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General NPI Number Information
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NPI Number | 1063632966
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Entity Type | Organization
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Legal Business Name | THE NEW DESTINY INC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 155 W WASHINGTON BLVD SUITE 517
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City | LOS ANGELES
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State | CA
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Zip | 90015-3552
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Country | US
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Telephone | 323-304-0054
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Fax | 213-749-1540
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Provider Business Mailing Address
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Address Line | 155 WEST WASHINGTON BLVD S SUITE 517
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City | LOS ANGELES
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State | CA
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Zip | 90015-0000
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Country | US
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Telephone | 323-304-0054
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Fax | 213-749-1540
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. NII AHUMA OCANSEY
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Credential |
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Telephone | 323-304-0054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 101YA0400X
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License Number State | CA
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